Primary Option

Hospitalisation

Subject to Overall Annual Benefit - M500,000.00 per beneficiary

Hospital Alternatives

M17,276.00 per beneficiary

Paramedical Services

100% of scheme rates

Blood Transfusion

M22,213.00 per beneficiary

Maternity

Subject to Overall Annual Benefit

Maxillofacial Surgery

Subject to Overall Annual Benefit

Mental Health
(In Hospital)

M20,000.00 per beneficiary, 3 days maximum if admitted by GP

Mental Health
(Out Of Hospital)

M1,500.00 per beneficiary

Oncology

M120,000.00 per beneficiary

Organ Transplant

M120,000.00 per beneficiary for tissue and organ transplant, M12,000.00 per beneficiary for specialized radiology (MRI & CAT scans)

Immune Deficiency

M7,404.00 per beneficiary

Renal Dialysis

M120,000.00 per family

Prosthetic Appliances

M30,000.00 per beneficiary for internal devices surgically implanted. M7,500.00 per beneficiary for external devices

Chronic Benefit

M3,000.00 per beneficiary

Dentistry

M1,256.00 per beneficiary

Optometry(Biannual benefit)

M1,917.00 per beneficiary, 100% of optometry benefit for prescribed lenses, M1,065.00 for frames

Pathology, Physical Therapy & Radiology

M3,500.00 per beneficiary

Consultation

M3,352.00 for Member. M2,346.00 for Spouse. M1,006.00 for Child. M1,508.00 for Student 21-26. M2,011.00 for Adult. 150 per script pbpd. OTC = 700 pbpa.